Active NPI
Nathan Bolander
- Pharmacist
- Shelley, ID
National Provider Identifier
1669854931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P7270
- Practice address
- 570 S State St
Shelley, ID 83274-1470 - Phone
- (208) 357-0473
- NPI assigned
- Jun 23, 2015
- Last updated
- Sep 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P7270 | ID | Primary |
Addresses
Primary practice location
570 S State St
Shelley, ID 83274-1470
Mailing address
570 S State St
Shelley, ID 83274-1470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P7270 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1669854931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 S STATE ST",
"city": "SHELLEY",
"state": "ID",
"postal_code": "832741470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 S STATE ST",
"city": "SHELLEY",
"state": "ID",
"postal_code": "832741470",
"telephone_number": "208-357-0473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLANDER",
"first_name": "NATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-23",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P7270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelley, ID
- Suzanna Marie Bird
- Joshua Darwin Bischoff, DPT
- Blackfoot Medical Clinic, Inc
- Kenneth Todd Blackner, M.D.
- BMH Inc (Physicians and Surgeons of Shelley)
- Samantha Ryleigh Brandt, DPT, PT
- Broulim Supermarkets, LLC (Broulim's Pharmacy #9 - Shelley)
- Chrystal Dawn Browning, PT, DPT, PCS
- Bryce D Hanson, DMD PA (River Valley Dental Care)
- Maria Magdalena Camacho, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.